KR102628659B1 - System and method for monitoring control points during reactive motion - Google Patents

Abstract

Systems and methods for monitoring control points during reactive movements include computer-assisted medical devices. The computer-assisted medical device includes one or more articulated arms, each having a control point, and a control unit coupled to the one or more articulated arms. The one or more articulated arms and corresponding control points are configured to track movement of the surgical table. The control unit may further comprise: determining an expected spatial configuration of the one or more control points during movement of the surgical table; determining an actual spatial configuration of the one or more control points during movement of the surgical table; and Monitoring the spatial configuration of the one or more control points by determining differences between the actual spatial configurations.

Description

SYSTEM AND METHOD FOR MONITORING CONTROL POINTS DURING REACTIVE MOTION}

The present invention relates generally to the operation of devices with articulated arms and in particular to monitoring control points during reaction movements.

More and more devices are being replaced by autonomous and semi-autonomous electronic devices. This applies especially to hospitals with large arrays of autonomous and semi-autonomous electronic devices found in operating rooms, interventional rooms, intensive care units, emergency rooms, etc. For example, glass and mercury thermometers are being replaced by electronic thermometers, intravenous syringes now contain electronic monitors and flow regulators, and traditional hand-held surgical instruments are being replaced by computer-assisted medical devices.

These electronic devices present advantages and challenges to the employees who operate them. Many of these electronic devices are capable of autonomous or semi-autonomous movement of one or more articulated arms and/or end effectors. Each of these one or more articulated arms and/or end effectors includes a combination of links and articulated joints that support movement of the articulated arms and/or end effectors. In many cases, the articulated joint is manipulated to obtain a desired position and/or orientation (collectively, a desired pose) of the links of the corresponding articulated arm and the corresponding device located at the distal end of the articulated joint. Each of the articulated joints proximate to the device provides at least one degree of freedom to the corresponding articulated arm that can be used to manipulate the direction and/or orientation of the corresponding device. In many cases, the corresponding articulated arm may include at least six degrees of freedom allowing for controlling the x, y, and z positions of the corresponding device as well as the roll, pitch, and yaw directions of the corresponding device. Each articulated arm may further provide a remote center of motion. In some cases, one or more articulated arms and their corresponding remote centers of motion or other points may be allowed to move to track movement of other parts of the electronic device. For example, when a device is inserted into a body opening, such as over a patient, incision site, or body cavity during a procedure, and the surgical table on which the patient is placed is in motion, the articulated arm may adjust the position of the device to changes in the position of the body opening. It is important to be able to adjust. Depending on the design and/or implementation of such articulated arm, the body opening above the patient may correspond to a remote center of motion for the articulated arm.

As each of these one or more articulated arms tracks the underlying movement, the corresponding articulated arm and/or other portions of the electronic device attempt to compensate for the movement of the body aperture. When these articulated arms are unable to fully compensate for movement of the body aperture points, this may lead to undesirable and/or unsafe results. Lack of correspondence with movement of the incision point may result in injury to the patient, breakage of the articulated arm, and/or other undesirable results.

US 2002/0161446 A1 (2002.10.31) US 6,120,433 A (2000.09.19) US 2007/0013336 A1 (2007.01.18)

Therefore, it would be desirable to monitor the function of the articulated arm to compensate for underlying movements of control points, such as body aperture.

According to some embodiments, a computer-assisted medical device includes one or more articulated arms, each having a control point, and a control unit coupled to the one or more articulated arms. The one or more articulated arms and corresponding control points are configured to track movement of the surgical table. The control unit may further comprise: determining an expected spatial configuration of the one or more control points during movement of the surgical table; determining an actual spatial configuration of the one or more control points during movement of the surgical table; and Monitoring the spatial configuration of the one or more control points by determining differences between the actual spatial configurations.

According to some embodiments, a method of monitoring the spatial configuration of one or more control points of a computer-assisted medical device includes: determining an expected spatial configuration of the one or more control points during movement of a surgical table; determining an actual spatial configuration of , and determining a difference between the expected spatial configuration and the actual spatial configuration. The one or more control points correspond to one or more articulated arms and are configured to track movement of the surgical table.

According to some embodiments, the non-transitory machine-readable medium includes a plurality of machine-readable instructions configured to, when executed by one or more processors associated with a medical device, cause the one or more processors to execute a method. The method includes determining an expected spatial configuration of the one or more control points during movement of a surgical table, determining a real spatial configuration of the one or more control points during movement of the surgical table, and the predicted spatial configuration and the actual space configuration. It involves determining the difference between. The one or more control points correspond to one or more articulated arms and are configured to track movement of the surgical table.

1 is a simplified diagram of a computer-assisted system according to some embodiments.
Figure 2 is a simplified diagram illustrating a computer-assisted system according to some embodiments.
3 is a simplified diagram illustrating a kinematic model of a computer-assisted medical system according to some embodiments.
4 is a simplified diagram of a method for monitoring one or more control points during table movement according to some embodiments.
5 is a simplified diagram of control point locations during table movement in height-only mode according to some embodiments.
Figure 6 is a simplified diagram of a constellation of control points during rotary table movement according to some embodiments.
7A-7G are schematic diagrams illustrating various computer-assisted device systems incorporating a movable surgical table and an integrated computer-assisted device described herein.
In the drawings, members with the same designation have the same or similar functions.

In the following description, specific details are set forth that describe some embodiments consistent with the invention. However, it will be understood by those skilled in the art that some embodiments may be practiced without some or all of these specific details. The specific embodiments disclosed herein are illustrative and not limiting. Those skilled in the art will appreciate that other elements, although not specifically described herein, are within the scope and spirit of the invention. Additionally, to avoid unnecessary repetition, one or more features shown and described in connection with one embodiment may be incorporated into another embodiment if not otherwise specified or if one or more features would render the embodiment non-functional. The term “including” means including but not limited to, and each of one or more individual items included should be considered optional unless otherwise stated. Likewise, the term “may” indicates that an item is optional.

1 is a simplified diagram of a computer assistance system 100 according to some embodiments. As shown in FIG. 1 , computer assistance system 100 includes device 110 having one or more movable or articulated arms 120 . Each of these one or more articulated arms 120 supports one or more end effectors. In some examples, device 110 may correspond to a computer-assisted surgical device. Each of these one or more articulated arms 120 provides support for one or more instruments, surgical instruments, imaging devices and/or the like mounted on at least one distal portion of the articulated arms 120 . Device 110 may be further coupled to an operator workstation (not shown), which may include one or more master controls, one or more articulated arms 120, and/or end effectors for operating device 110. there is. In some embodiments, device 110 and operator workstation may correspond to the da ^Vinci® Surgical System sold by Intuitive Surgical, Inc. of Sunnyvale, California. In some embodiments, computer-assisted surgical devices with other configurations, fewer or more articulated arms, and/or the like may optionally be used with computer-assisted system 100.

Device 110 is coupled to control unit 130 via an interface. Such interfaces may include one or more wireless links, cables, connectors, and/or buses and may further include one or more networks with one or more network switching and/or routing devices. Control unit 130 includes a processor 140 coupled to memory 150 . The operation of the control unit 130 is controlled by the processor 140. Although control unit 130 is shown as having only one processor 140, processor 140 may include one or more central processing units, multi-core processors, microprocessors, microcontrollers, or digital signal processors within control unit 130. , it should be understood that it may refer to a field programmable gate array (FPGA), an application specific integrated circuit (ASIC), and/or something else. Control unit 130 may be implemented as a standalone subsystem and/or board added to a computing device or as a virtual machine. In some embodiments, the control unit may be included as part of an operator workstation and/or operated separately from, but in conjunction with, the operator workstation.

Memory 150 is used to store software executed by control unit 130 and/or one or more data structures used during operation of control unit 130. Memory 150 may include one or more types of machine-readable media. Some common forms of machine-readable media include floppy disks, flexible disks, hard disks, magnetic tape, any other magnetic media, CD-ROMs, any other optical media, punch cards, paper tape, any other magnetic media, any media with a pattern of holes. It may include other physical media, RAM, PROM, EPROM, FLASH-EPROM, any other memory chip or cartridge, and/or any other media configured to be read by a processor or computer.

As shown, memory 150 includes a motion control application 160 that supports autonomous and/or semi-autonomous control of device 110. Motion control application 160 may receive position, motion, and/or sensor information from device 110 and position, motion, and/or collide with other control units for other devices, such as surgical tables and/or imaging devices. Program one or more applications to exchange avoidance information, and/or plan motion for and/or assist in planning motion for device 110, articulated arm 120, and/or end effectors of device 110. May include an interface (API). And although motion control application 160 is shown as a software application, motion control application 160 may be implemented using hardware, software, and/or a combination of hardware and software.

In some embodiments, computer support system 100 may be found in an operating room and/or a control room. And although computer-assisted system 100 includes only one device 110 with two articulated arms 120, computer-assisted system 100 may be of similar and/or different design than device 110. Those skilled in the art will understand that the device may include any number of devices having articulated arms and/or end effectors. In some examples, each of these devices may include fewer or more articulated arms and/or end effectors.

The computer-assisted system 100 further includes a surgical table 170. Like one or more articulated arms 120 , the surgical table 170 supports articulated movement of the table top 180 relative to the base of the surgical table 170 . In some examples, articulated movement of the table top 180 may include supports to change the height, tilt, slide, Trendelenburg direction, etc. of the table top 180. Although not shown, surgical table 170 may include one or more control inputs, such as a surgical table command unit, for controlling the position and/or orientation of table top 180. In some embodiments, surgical table 170 may correspond to one or more of the surgical tables sold by Trumpf Medical Systems GmbH of Germany.

The surgical table 170 is also coupled to the control unit 130 via a corresponding interface. Such interfaces may include one or more wireless links, cables, connectors, and/or buses, and may further include one or more networks with one or more network switching and/or routing devices. In some embodiments, surgical table 170 may be coupled to a different control unit than control unit 130 . In some examples, motion control application 160 includes one or more application programming interfaces (APIs) for receiving position, motion, and/or other sensor information associated with surgical table 170 and/or table top 180. can do. In some examples, motion control application 160 may help plan and/or plan motion for surgical table 170 and/or surgical upper 180 . In some examples, motion control application 160 may be used to control movement of the articulated arm, device, end effector, surgical table component, etc. by avoiding limited ranges of motion of the joints and links of the articulated arm, device, end effector, surgical table component, etc. Contribute to a motor plan associated with collision avoidance, configured to compensate for other movements of the back and adjust a viewing device, such as an endoscope, to maintain and/or position a region of interest and/or one or more devices or end effectors within the field of view of the viewing device. You can. In some examples, the motion control application 160 may control the surgical table 170 and/or the table top 180, such as preventing movement of the surgical table 170 and/or table top 180 by using a surgical table command unit. 180) motion can be prevented. In some examples, motion control application 160 may assist register device 110 with surgical table 170 to know the geometric relationship between register device 110 and surgical table 170. In some examples, the geometric relationship may include translation and/or one or more rotations between coordinate frames maintained relative to register device 110 and surgical table 170 .

Figure 2 is a simplified diagram illustrating a computer assistance system 200 according to some embodiments. For example, computer assistance system 200 may coincide with computer assistance system 100. As shown in Figure 2, computer-assisted system 200 includes a surgical table 280 and a computer-assisted device 210 having one or more articulated arms. Although not shown in Figure 2, computer-assisted device 210 and surgical table 280 may be coupled together using one or more interfaces and one or more control units such that kinematic information for at least surgical table 280 is provided to the computer-assisted device. It is known in motion control applications that it is used to execute the motion of an articulated arm (210).

Computer-assisted device 210 includes various links and joints. In the embodiment of Figure 2, the computer-assisted device is generally divided into three different sets of links and joints. First, there is a set-up structure 220 at the mobile cart 215 or the adjacent end of the patient side cart 215. The distal end of this setup structure is coupled with a series of links and setup joints 240 forming an articulated arm. And a multi-joint manipulator 260 is coupled to the distal end of the setup joint 240. In some examples, a series of setup joints 240 and manipulator 260 may correspond to one of the articulated arms 120. And although the computer-assisted device is shown as having only one series of set-up joints 240 and corresponding manipulators 260, those skilled in the art will understand that the computer-assisted device may have more than one series of set-up joints 240 and corresponding manipulators ( 260), so that the computer-assisted device may be equipped with a plurality of articulated arms.

As shown, computer aided device 210 is mounted on mobile cart 215. This mobile cart 215 allows the computer-assisted device 210 to be moved, such as between or within an operating room, to better position the computer-assisted device in proximity to the surgical table 280. The setup structure 220 is mounted on a mobile cart 215. As shown in Figure 2, setup structure 220 includes a two-part column including column links 221 and 222. A shoulder joint 223 is coupled to the upper or distal end of the column link 222. A two-part boom including boom links 224 and 225 is coupled to the shoulder joint 223. There is a wrist joint 226 at the distal end of the boom link 225, and an arm mounting platform 227 is coupled to the wrist joint 226.

The links and joints of the setup structure 220 include various degrees of freedom for changing the position and orientation (i.e., pose) of the arm mounting platform 227. For example, a two-part column may be used to adjust the height of arm mounting platform 227 by moving shoulder joint 223 along axis 232. This arm mounting platform 227 can be further rotated relative to the mobile cart 215, two-part column, and axle 232 using shoulder joints 223. The horizontal position of arm mounting platform 227 can be adjusted along axis 234 using a two-part boom. And the orientation of the arm mounting platform 227 can also be adjusted by rotating about the arm mounting platform orientation axis 236 using the wrist joint 226. Accordingly, by the motion limits of the links and joints of the setup structure 220, the position of the arm mounting platform 227 can be adjusted vertically above the mobile cart 215 using a two-part column. The position of the arm mounting platform 227 can also be adjusted radially and angularly relative to the mobile cart 215 using two-part boom and shoulder joints 223, respectively. And the angular direction of the arm mounting platform 227 can also be changed using the wrist joint 226.

Arm mounting platform 227 may be used as a mounting point for one or more articulated arms. The ability to adjust the height, horizontal position, and orientation of the arm mounting platform 227 relative to the mobile cart 215 allows the user to adjust the height, horizontal position, and orientation of the arm mounting platform 227 relative to a workspace, such as a patient, located in the vicinity of the mobile cart 215 where the surgery or procedure is performed. Provides a flexible setup structure for positioning and orienting one or more articulated arms. For example, an arm mounting platform 227 can be positioned over a patient so that the various articulated arms and their corresponding manipulators and devices have a sufficient range of motion to perform procedures on the patient. 2 shows a single articulated arm coupled to an arm mounting platform 227 using a first setup joint 242. And, although only one articulated arm is shown, those skilled in the art will understand that multiple articulated arms may be coupled to arm mounting platform 227 using additional first setup joints.

The first set-up joint 242 forms the proximal portion of the set-up joint 240 section of the articulated arm. Setup joint 240 may further include a series of joints and links. As shown in FIG. 2 , setup joint 240 includes at least links 244 and 246 coupled via one or more joints (not clearly shown). The joints and links of the set-up joint 240 rotate the set-up joint 240 relative to the arm mounting platform 227 about the axis 252 using the first set-up joint 242, and the first set-up joint 242 ) and the link 246, adjusting the height of the manipulator mount 262 at the distal end of the link 246 relative to the orientation platform along axis 254, and manipulator mount 262. It includes the function of rotating about the axis 254. In some examples, setup joint 240 may further include additional joints, links, and axes to allow additional degrees of freedom to change the pose of manipulator mount 262 relative to arm mounting platform 227.

The manipulator 260 is coupled to the distal end of the setup joint 240 through a manipulator mount 262. Manipulator 260 includes additional joints 264 and links 266 along with an instrument carriage 268 mounted on the distal end of manipulator 260. Instrument 270 is mounted on instrument carriage 268. This device 270 includes a shaft 272 aligned along an insertion axis. Shaft 272 is usually arranged to pass through a remote center of motion 274 associated with manipulator 260. The position of the telemotion center of motion 274 is usually maintained in a fixed translational relationship with respect to the manipulator mount 262 such that the motion of the joint 264 of the manipulator 260 causes the shaft (274) to shift relative to the telemotion center of motion 274. 272) rotates. According to this embodiment, the fixed translational relationship of the telemotion center of motion 274 with respect to the manipulator mount 262 uses the physical constraints of the joints 264 and links 266 of the manipulator 262 to ) is maintained using software constraints on the allowed movements, and/or a combination of the two. A representative example of a computer-assisted surgical device using a remote center of motion that is manipulated using the physical constraints of the joints and links is “Redundant Axis and Degree of Freedom for Hardware-Constrained Remote Center Robotic Manipulator,” filed May 13, 2013. A representative embodiment of a computer-assisted surgical device using remote sensors of motion manipulated by software constraints is described in U.S. Patent Application Serial No. 13/906,888, entitled “Software Center and Highly,” filed May 10, 2005. No. 8,004,229, entitled “Configurable Robotic Systems for Surgery and Other Uses,” the contents of which are hereby incorporated by reference in their entirety. In some examples, remote center of motion 274 may correspond to a location above a body opening, such as an incision site or body cavity, within patient 278 when shaft 272 is inserted into patient 278. Because the remote center of motion 274 corresponds to the surgical port, when the device 270 is used, the remote center of motion 274 remains stationary with respect to the patient 278 such that the patient is at the remote center of motion 274. Limits stress on the human body (278). In some examples, shaft 272 may optionally pass through a cannula (not shown) positioned in a surgical port. In some examples, a device having a relatively larger shaft or guide tube outer diameter (e.g., 4-5 mm or more) may be passed through a body opening using a cannula, which cannula may have a relatively smaller shaft or guide tube outer diameter. (e.g., 2-3 mm or less) may optionally be omitted.

There is an end effector 276 at the distal end of the shaft 272. The degree of freedom of the manipulator 260 due to the joints 264 and links 266 allows the roll, pitch, and yaw of the shaft 272 and/or end effector 276 to be controlled, at least with respect to the manipulator mount 262. there is. In some examples, the degrees of freedom of the manipulator 260 further include the ability to advance and/or retract the shaft 272 using the instrument carriage 268 so that the end effector 276 is positioned along the insertion axis and the remote center of motion. It may be advanced and/or retracted relative to 274. In some examples, manipulator 260 may be consistent with a manipulator for use with the da ^Vinci® Surgical System sold by Intuitive Surgical Incorporated, Sunnyvale, California. In some examples, device 270 may be an imaging device such as an endoscope, a gripper, a surgical instrument such as a cautery or scalpel, etc. In some examples, end effector 276 may include additional degrees of freedom, such as roll, pitch, elements, grips, etc., that allow for additional local manipulation of portions of end effector 276 relative to the distal end of shaft 272. .

During surgery or other medical procedures, patient 278 is typically positioned on an operating table 280. The surgical table 280 includes a table base 282 and a table top 284 with the table base 282 positioned proximate to the mobile cart 215 to accommodate the instrument 270 and/or end effector 276. Can be manipulated by computer-assisted device 210 while shaft 272 of device 270 is inserted into a body opening of patient 278. The surgical table 280 further includes an articulated structure 290 that includes one or more joints or links between the table base 282 and the table top 284, relative to the table base 282. ), so that the relative position of the patient 278 can be controlled. In some examples, the articulated structure 290 may be configured to control the table top 284 relative to a virtual defined table motion iso center 286 that can be located at a point on the table top 284. You can. In some examples, isocenter 286 may be located internal to patient 278. In some examples, isocenter 286 may be flush with the patient's body wall at or near one of the body openings, such as a body opening site corresponding to remote center of motion 274.

As shown in FIG. 2 , the articulated structure 290 includes a height adjustment joint 292 to allow the table top 824 to be raised and/or lowered relative to the table base 282 . The articulated structure 290 further includes joints and links to change both the tilt 296 and Trendelenburg 296 directions of the table top 284 with respect to the isocenter 286. Due to this tilt 294, the table top 284 can be tilted left and right so that the left or right side of the patient 278 is tilted upward with respect to the other side of the patient 278 (i.e., in the longitudinal direction of the table top 284). , or rotated about the superior-inferior (cranial-coccygeal) axis. The table top 284 is rotated by the Trendelenburg 296 to raise the feet of the patient 278 (Trendelenburg) or the head of the patient 278 (reverse Trendelenburg). In some examples, tilt 294 and/or Trendelenburg 296 rotation can be adjusted to produce rotation about isocenter 286. The articulated structure 290 includes additional links and additional links to allow the table top 284 to slide along the longitudinal (cranio-coccygeal) axis relative to the table base 282 in approximately left and/or right motion as shown in FIG. 2 . It further includes a joint (298).

7A-7G are simplified schematic diagrams illustrating various computer-assisted device system architectures including integrated computer-assisted device and moveable surgical table features described herein. These various illustrated system components are in accordance with the principles described herein. In these drawings, the components are simplified for understanding, and various details such as individual links, joints, manipulators, devices, end effectors, etc. are not shown, but should be understood as being included in the various components.

In these structures, cannulas associated with one or more surgical instruments or clusters of instruments are not shown, and the cannulas and other instrument guide devices have relatively larger shaft or guide tube outer diameters (e.g., 4-5 mm or more). Alternatively, it should be understood that it may be used as an option for instrument clusters and may be optionally omitted for instruments with relatively smaller shaft or guide tube outer diameters (e.g., 2-3 mm or less).

Additionally, in this configuration, the telecontrolled manipulator may be either hardware constrained (e.g., fixed cross-instrument pitch, yaw, and roll axes) or software-constrained (e.g., software-constrained cross-instrument pitch, yaw, and roll axes) during surgery. It should be understood as including a manipulator that defines the center of remote movement by using . It is also possible for hybrids of these device rotation axes to be specified (e.g. hardware constrained roll axes and software constrained pitch and yaw axes). Additionally, some manipulators are unable to define and constrain any surgical instrument axis of rotation during a procedure, and some manipulators are only able to define and constrain one or more device axes of rotation during a procedure.

FIG. 7A illustrates a movable surgical table 1100 and a single instrument computer assisted device 1101a. The surgical table 1100 includes a movable table top 1102 and a table support structure 1103 extending from a mechanically grounded table base 1104 to support the table top 1102 at its distal end. In some examples, surgical table 1100 may coincide with surgical table 170 and/or 280. The computer-assisted device 1101a includes a remote control manipulator and a single instrument assembly 1105a. The computer assistance device 1101a also includes a support structure 1106a that is mechanically grounded at the proximal base 1107a and extends at its distal end to support the manipulator and instrument assembly 1105a. The support structure 1106a is configured to allow the assembly 1105a to be moved relative to the surgical table 1100 and held in various fixed positions. The base 1107a is optionally permanently fixed or movable relative to the surgical table 1100. Surgical table 1100 and computer-assisted device 1101a operate together as described herein.

FIG. 7A also shows that two, three, four, five or more individual computer-assisted devices may be included, with corresponding individual telecontrol manipulators and single-instrument assemblies 1105b supported by corresponding support structures 1106b. An optional second computer assistance device 1101b is shown. Computer-assisted device 1101b is mechanically grounded and assembly 1105b has a similar pose as computer-aided device 110a. Surgical table 1100 and computer-assisted devices 1101a, 1101b together create a multi-instrument surgical system, which operates together as described herein. In some examples, computer-assisted devices 110a and/or 1101b may coincide with computer-assisted devices 110 and/or 210.

As shown in Figure 7B, another movable surgical table 1100 and computer-assisted device 1111 are shown. Computer-assisted device 1111 is a multi-instrument device comprising two, three, four, five or more individual remote control manipulators and single-instrument assemblies, as shown by representative manipulator and instrument assemblies 1105a and 1105b. . The assemblies 1105a, 1105b of the computer-assisted device 1111 are supported by a coupled support structure 1112 so that the assemblies 1105a, 1105b can be moved and posed together as a group relative to the surgical table 1100. The assemblies 1105a, 1105b of the computer assistance device 1111 are also supported by corresponding individual support structures 1113a, 1113b, respectively, such that each assembly 1105a, 1105b is supported on the surgical table 1100 and one or more other assemblies. 1105a and 1105b can be moved and posed individually. Examples of each multi-instrument surgical system structure are the da Vinci Si® Surgical System and da Vinci® Xi™ Surgical System, sold by Intuitive Surgical Incorporated. A surgical manipulator system including an exemplary computer-assisted device 1111 and surgical table 1100 operate together as described herein. In some examples, computer-assisted device 1111 coincides with computer-assisted device 110 and/or 210.

The computer aided devices of FIGS. 7A and 7B are each shown mechanically grounded to the floor. However, one or more of these computer-assisted devices may optionally be mechanically grounded to a wall or ceiling and may be permanently fixed or movable relative to such wall or ceiling. In some examples, the computer-assisted device may be mounted to a wall or ceiling using a track or grid system that allows the support base of the computer-assisted system to be moved relative to the surgical table. In some examples, one or more fixed or releasable mounting clamps may be used to mount each support base to such a track or grid system. As shown in Figure 7C, computer aided device 1121a is mechanically grounded to the wall and computer aided device 1121b is mechanically grounded to the ceiling.

Additionally, the computer-assisted device may be mechanically grounded indirectly through the movable surgical table 1100. As shown in FIG. 7D, the computer-assisted device 1131a is coupled to the table top 1102 of the surgical table 1100. Computer-assisted device 1131a may optionally be coupled to other parts of surgical table 1100, such as table support structure 1103 or table base 1104, as shown by the dashed structures in FIG. 7D. As table top 1102 moves relative to table support structure 1103 or table base 1104, computer assisted device 1131 moves relative to table support structure 1103 or table base 1104 as well. However, when computer aided device 1131a is coupled to table support structure 1103 or table base 1104, the base of computer aided device 1131a remains fixed relative to the ground when table top 1102 moves. There will be. As table movement occurs, the body opening through which the device is inserted into the patient may also move because the patient's body may move and change body position relative to the table top 1102. Accordingly, in embodiments where the computer-assisted device 1131a is coupled to the table top 1102, the table top 1102 functions as a local machine ground, the body opening moves relative to the table top 1102, and the computer-assisted device 1131a is coupled to the table top 1102. It also moves to device 1131a. FIG. 7D also shows that a second computer aided device 1131b, configured similarly to the computer assisted device 1131a, can be optionally added to create a multi-device system. A system comprising one or more computer-assisted devices coupled to such a surgical table operates as disclosed herein.

In some embodiments, different combinations of computer-assisted devices with identical or hybrid mechanical grounds are possible. For example, it may include one computer-aided device mechanically grounded to the floor, and a second computer-aided device mechanically grounded to the floor through a surgical table. This hybrid mechanical grounding system operates as disclosed herein.

This feature also includes a single-body opening system in which two or more surgical instruments enter the body through a single body opening. Examples of such systems include U.S. Patent No. 8,852,208, entitled “Surgical System Instrument Mounting,” filed August 12, 2010, and “Minimally Invasive Surgical System,” filed June 13, 2007, which are incorporated herein by reference. See U.S. Patent No. 9,060,678, entitled " FIG. 7E shows a remote controlled multi-instrument computer assisted device 1141 in conjunction with a surgical table 1100 as described above. Two or more devices 1142 are each coupled to a corresponding manipulator 1143 and the cluster of devices 1142 and device manipulators 1143 are moved together by the system manipulator 1145. This system manipulator 1144 is supported by a support assembly 1145 that allows the system manipulator 1144 to be moved and held in various poses. Support assembly 1145 is mechanically grounded to base 1146 consistent with the description above. Two or more devices 1142 are inserted into the patient at a single body opening. Optionally, the devices 1142 extend together through a single guide tube, which optionally extends through a cannula, as described in the above-mentioned literature. Computer-assisted device 1141 and surgical table 1100 operate together as described herein.

7F illustrates another multi-instrument, single body aperture computer-assisted device optionally coupled to table top 1102, table support structure 1103, or table base 1104 and mechanically grounded through surgical table 1100. (1151) is shown. The above description of FIG. 7D also applies to the mechanical grounding option shown in FIG. 7F. Computer-assisted device 1151 and surgical table 1100 operate together as described herein.

7G illustrates one or more telecontrolled multi-instrument, single body opening computer assisted devices 1161 and one or more telecontrolled single-instrument computer assisted devices 1162 for operation with a surgical table 1100 as described herein. It shows that they can be combined. Each of computer aided devices 1161, 1162 may be mechanically grounded in a variety of ways described herein, either directly or through other structures.

3 is a simplified diagram of a kinematic model 300 of a computer-assisted medical system according to some embodiments. As shown in Figure 3, kinematic model 300 may include kinematic information associated with many sources and/or devices. This kinematic information is based on known kinematic models for the links and joints of computer-assisted medical devices and surgical tables. This kinematic information is also based on information associated with the position and/or orientation of joints of the computer-assisted medical device and the surgical table. In some examples, information associated with the position and/or orientation of such joints may be derived from one or more sensors, such as encoders, that measure the linear position of the prismatic joint and the rotational position of the rotary joint.

This kinematic model 300 includes multiple coordinate frames or coordinate systems and transformations, such as homogeneous transformations, to transform position and/or orientation from one of the coordinate frames to another of the coordinate frames. In some examples, kinematic model 300 can transform the position and/or orientation of one of the coordinate frames from any other of the coordinate frames by constructing forward and/or inverse/inverse transformations indicated by the transformation links included in Figure 3. and/or may be used to allow reverse mapping. In some examples, when the transformation is modeled as a homogeneous transformation in matrix form, this construction can be achieved using matrix multiplication. In some embodiments, kinematic model 300 may be used to model the kinematic relationships of computer-aided device 210 and surgical table 280 of FIG. 2 .

Kinematic model 300 includes a table base coordinate frame 305 that is used to model the position and/or orientation of a surgical table, such as surgical table 170 and/or surgical table 280. In some examples, this table base coordinate frame 305 may be used to model other points on the surgical table relative to reference points and/or orientations associated with the surgical table. In some examples, these reference points and/or directions may be associated with a table base of a surgical table, such as table base 282. In some examples, table base coordinate frame 305 may be suitable for use as a global coordinate frame for a computer-assisted system.

Kinematic model 300 further includes a table top coordinate frame 310 that can be used to model positions and/or orientations in a coordinate frame representing the table top of a surgical table, such as table top 284. In some examples, table top coordinate frame 310 may be centered at an isocenter of the table top, such as a rotation center or isocenter 286. In some examples, the z-axis of the table top coordinate frame 310 may have an orientation perpendicular to the surface or floor on which the surgical table rests and/or perpendicular to the surface of the table top. In some examples, the x- and y-axes of table top coordinate frame 310 may be oriented to capture the longitudinal (up and down) and lateral (left and right) major axes of the table top. In some examples, table base to table top coordinate transformation 315 may be used to map positions and/or orientations on table top coordinate frame 310 and table base coordinate frame 305. In some examples, one or more kinematic models of the articulated structure of the surgical table, such as articulated structure 290, are used in conjunction with past and/or current joint sensor readings to determine the table base-to-table top coordinate transformation 315. do. In some examples, consistent with the embodiment of FIG. 2 , table base to table top coordinate transformation 315 models the composite effects of height, tilt, Trendelenburg, and/or slide settings associated with a surgical table.

Kinematic model 300 further includes a device base coordinate frame that can be used to model the position and/or orientation of a computer-assisted device, such as computer-assisted device 110 and/or computer-assisted device 210 . In some examples, device base coordinate frame 320 may be used to model other points of a computer-assisted device with respect to a reference point and/or orientation associated with the computer-assisted device. In some examples, these reference points and/or directions may be associated with the device base of a computer-assisted device, such as mobile cart 215. In some examples, device base coordinate frame 320 may be suitable for use as a global coordinate frame for a computer-assisted system.

It is desirable to perform registration between the surgical table and the computer-assisted device to track the positional and/or directional relationship between the surgical table and the computer-assisted device. As shown in Figure 3, this registration can be used to determine a registration transformation 325 between the table top coordinate frame 310 and the device base coordinate frame 320. In some embodiments, registration transformation 325 may be a partial or complete transformation between table top coordinate frame 310 and device base coordinate frame 320. This registration transformation 325 is determined based on the structural arrangement between the surgical table and the computer-assisted device.

7D and 7F where the computer aided device is mounted on the table top 1102, the registration transformation 325 is determined by the table base to table top coordinate transformation 315 and the computer aided device is mounted on the table top 112. Know where it is mounted.

In the examples of FIGS. 7A-7C, 7E, and 7F where these computer-assisted devices are placed on the floor or mounted on a wall or ceiling, the determination of the registration transformation 325 involves the device base coordinate frame 320 and the table base coordinate frame. (305) is simplified by some restrictions. In some examples, these constraints include that device base coordinate frame 320 and table base coordinate frame 305 coincide with the same vertical or z-axis. Assuming that the surgical table is positioned on the floor and that the relative orientations of the room's walls (e.g., perpendicular to the floor) and the ceiling (e.g., parallel to the floor) are known, a common vertical upward or z-axis (or appropriate orientation) is assumed. It is possible for the transformation) to be maintained for both the device base coordinate frame 320 and the table base coordinate frame 305 or an appropriate orientation transformation. In some examples, because of the common z-axis, registration transformation 325 may optionally model only the rotational relationship of the device base to table base about the z-axis of table base coordinate frame 305 (e.g., θz registration ). In some examples, registration transformation 325 may also model a horizontal offset between table base coordinate frame 305 and device base coordinate frame 320 (e.g., XY registration). This is possible because the vertical (z) relationship between the computer-assisted device and the surgical table is known. Accordingly, the change in height of the table top of the table base to table top translation 315 is similar to the vertical adjustment of the device base coordinate frame 320 because the table base coordinate frame 305 and the device base coordinate frame 320 This is because the vertical axes of ) are the same or almost the same, so the change in height between the table base coordinate frame 305 and the device base coordinate frame 320 is within an appropriate tolerance. In some examples, tilt and Trendelenburg adjustments in the table base to table top translation 315 can be made by knowing the height and θz and/or XY registration of the table top (or its isocenter) in the device base coordinate frame 320. can be mapped. In some examples, registration transformation 325 and table base-to-table top transformation 315 may be used to model a computer-assisted surgical device as if attached to a table top, even when this is not structurally the case.

Kinematic model 300 further includes an arm mounting platform coordinate frame 330 that is used as an appropriate model for the shared coordinate frame associated with the nearest points of the articulated arms of the computer-assisted device. In some embodiments, arm mounting platform coordinate frame 330 may be associated with a nearby point on the arm mounting platform, such as arm mounting platform 227. In some examples, the center point of arm mounting platform coordinate frame 330 is located on arm mounting platform orientation axis 236 with the z-axis of arm mounting platform coordinate frame 330 aligned with arm mounting platform orientation axis 236. It can be. In some examples, device base-to-arm mounting platform coordinate frame 335 is used to map positions and/or orientations between device base coordinate frame 320 and arm mounting platform coordinate frame 330. In some examples, one or more kinematic models of the links and joints of a computer-aided device, such as set-up structure 220, between the device base and arm mounting platform, along with past and/or current joint sensor readings Used to determine the coordinate frame 335. In some examples consistent with the embodiment of Figure 2, device base-arm mounting platform coordinate transformation 335 is a composite effect of the two-part column, shoulder joint, two-part boom, and wrist joint of the setup structure of the computer-assisted device. can be modeled.

Kinematic model 300 further includes a series of coordinate frames and transformations associated with each of the articulated arms of the computer-assisted device. As shown in FIG. 3, kinematic model 300 includes coordinate frames and transformations for three articulated arms, but those skilled in the art will recognize that different computer aids (e.g., 1, 2, 4, 5 or more ) may include fewer and/or more articulated arms. Consistent with the configuration of the links and joints of the computer-assisted device 210 of FIG. 2, each of the articulated arms has a manipulator-mounted coordinate frame, a remote center coordinate frame, and, depending on the type of device mounted on the distal end of the articulated arm, It is modeled using the device or camera coordinate frame.

In the kinematic model 300, the kinematic relationships of the first of the articulated arms are the manipulator mount coordinate frame 341, the telecentric coordinate frame 342, the device coordinate frame 343, and the arm mounting platform-to-manipulator mounting transformation 344. ), manipulator mount-to-remote motion center transformation (345), and remote motion center-to-device transformation (346). Manipulator mount coordinate frame 341 represents a suitable model for representing the position and/or orientation associated with a manipulator, such as manipulator 260. The manipulator mount coordinate frame 341 is associated with a manipulator mount such as the manipulator mount 262 of the corresponding articulated arm. Arm-mounted platform-to-manipulator mounting transformation 344 then connects the arm-mounted platform and the corresponding manipulator, such as the corresponding set-up joint 240, with past and/or current joint sensor readings of the corresponding set-up joint 240. The computer-aided device is based on one or more kinematic models of the links and joints between the mounts.

The center of telemotion coordinate frame 342 is associated with a center of telemotion of a device mounted on a manipulator, such as a corresponding center of telemotion 274 of a corresponding manipulator 260 . The manipulator mount-to-remote motion center translation 345 then converts the corresponding joint 264 of the corresponding manipulator 260, the corresponding link ( 266), and a corresponding carriage 268, based on one or more kinematic models of the links and joints of the computer-assisted device between a corresponding manipulator mount and a corresponding remote center of motion. When the corresponding telecenter of motion is maintained in a fixed positional relationship to the corresponding manipulator mount, such as the embodiment of Figure 2, the manipulator mount-to-telemotion center translation 345 essentially causes the manipulator and device to actuate. It contains a static translational element that does not change, and a dynamic rotational element that changes as the manipulator and device are operated.

Device coordinate frame 343 is associated with an end effector located at the distal end of the device, such as a corresponding end effector 276. The remote center-of-motion-to-device translation 346 then, together with past and/or current joint sensor readings, provides information about the corresponding devices, end effectors, and links and joints of the computer-assisted device that moves and/or orients the remote center of motion. It is based on one or more kinematic models. In some examples, the remote center of motion to device translation 346 processes the direction in which a shaft, such as the corresponding shaft 272, passes through the remote center of motion and the distance that such shaft advances and/or retreats with respect to the remote center of motion. do. In some examples, remote center of motion to device translation 346 may be constrained to reflect the insertion axis of the shaft of the device passing through the remote center of motion and handle rotation of the shaft and end effector about the axis defined by the shaft. do.

In the kinematic model 300, the kinematic relationships of the second articulated arm of the articulated arm are the manipulator mount coordinate frame 351, the remote center of motion coordinate frame 352, the instrument coordinate frame 353, and the arm mounting platform-manipulator mount. Captured using transformation (354), mount-to-remote motion center transformation (355), and remote motion center-to-device transformation (356). Manipulator mount coordinate frame 351 represents a suitable model for representing the position and/or orientation associated with a manipulator, such as manipulator 260. The manipulator mount coordinate frame 351 is associated with a manipulator mount such as the manipulator mount 262 of the corresponding articulated arm. The arm mounting platform-to-manipulator mounting transformation 354 then connects the arm mounting platform and the corresponding manipulator mount, such as the corresponding setup joint 240, with past and/or current joint sensor readings of the corresponding setup joint 240. The computer-assisted device is based on one or more kinematic models of links and joints.

The telemotion center coordinate frame 352 is associated with a telemotion center of a manipulator mounted on an articulated arm, such as a corresponding telemotion center of motion 274 of a corresponding manipulator 260 . The manipulator mount-to-remote motion center translation 355 then converts the corresponding joint 264 of the corresponding manipulator 260, the corresponding link ( 266), and a corresponding carriage 268, based on one or more kinematic models of the links and joints of the computer-assisted device between a corresponding manipulator mount and a corresponding remote center of motion. When the corresponding remote center of motion is maintained in a fixed positional relationship relative to the corresponding manipulator mount, as in the embodiment of Figure 2, mount-to-remote center of motion translation 355 essentially allows the manipulator and device to operate. It includes a static translational element that does not change when the manipulator and the device are operated and a dynamic rotational element that changes when the device is operated.

Device coordinate frame 353 is associated with a corresponding device 270 and/or an end effector located at the distal end of the device, such as end effector 276. Then, the remote center of motion to device translation 356 is one of the links and joints of the computer-assisted device that moves and/or orients the corresponding device, end effector, and remote center of motion, along with historical and/or joint sensor readings. It is based on the above kinematic model. In some examples, remote center of motion-to-device translation 356 may determine the direction in which the shaft passes through the remote center of motion, and the distance the shaft advances and/or retreats relative to the remote center of motion, such as the corresponding shaft 272. Process it. In some examples, remote center of motion to device translation 356 may be suppressed to reflect the insertion axis of the shaft of the device passing through the remote center of motion and rotation of the shaft and end effector about the insertion axis defined by the shaft. can be processed.

In the kinematic model 300, the kinematic relationships of the third articulated arm of the articulated arm are the manipulator mount coordinate frame 361, the remote center of motion coordinate frame 362, the camera coordinate frame 363, and the arm mounting platform-manipulator mount. Captured using transformation (364), manipulator mount-to-remote motion center transformation (365), and telemotion center-to-device transformation (366). Manipulator mount coordinate frame 361 represents a suitable model for representing the position and/or orientation associated with a manipulator, such as manipulator 260. The manipulator mount coordinate frame 361 is associated with a manipulator mount such as the manipulator mount 262 of the corresponding articulated arm. The arm mounting platform-to-manipulator mounting transformation 364 then connects the arm mounting platform and the corresponding manipulator mount, such as the corresponding setup joint 240, with past and/or current joint sensor readings of the corresponding setup joint 240. The computer-assisted device is based on one or more kinematic models of links and joints.

The telemotion center coordinate frame 362 is associated with a telemetry center of motion of a manipulator mounted on an articulated arm, such as a corresponding telemotion center of motion 274 of a corresponding manipulator 260 . The manipulator mount-to-remote motion center translation 365 then converts the corresponding joint 264 of the corresponding manipulator 260, the corresponding link ( 266), and a corresponding carriage 268, based on one or more kinematic models of the links and joints of the computer-assisted device between a corresponding manipulator mount and a corresponding remote center of motion. When the corresponding remote center of motion is maintained in a fixed positional relationship relative to the corresponding manipulator mount, as in the embodiment of Figure 2, mount-to-remote center of motion translation 365 essentially allows the manipulator and device to operate. It includes a static translational element that does not change when the manipulator and the device are operated and a dynamic rotational element that changes when the device is operated.

Camera coordinate frame 363 is associated with an imaging device, such as an endoscope, mounted on an articulated arm. The remote center-of-motion-to-camera translation 366 then, together with the historical and/or joint sensor readings, may be used to determine one or more kinematics of the links and joints of the computer-assisted device to move and/or orient the imaging device and the corresponding remote center of motion. It is based on a model. In some examples, the remote center of motion-to-camera translation 366, such as the corresponding shaft 272, determines the direction through which the shaft passes through the remote center of motion and the distance the shaft advances and/or retreats relative to the remote center of motion. Process it. In some examples, remote center of motion-to-camera translation 366 may be suppressed to reflect the insertion axis of the shaft of the imaging device passing through the remote center of motion and handle rotation of the imaging device about the axis defined by the shaft. can do.

As stated above and further emphasized herein, Figure 3 is merely an example and does not limit the scope of the claims. Those skilled in the art will appreciate many modifications, alternatives, and modifications. According to some embodiments, registration between a surgical table and a computer-assisted device may be determined between table top coordinate frame 310 and device base coordinate frame 320 using an alternative registration transformation. When an alternative registration transformation is used, the registration transformation 325 is determined by constructing the alternative registration transformation as an inversion/reverse of the table base-to-table top transformation 315. According to some embodiments, the coordinate frames and/or transformations used to model the computer-assisted device may be related to specific configurations of the computer-assisted device, its articulated arms, its end effectors, its manipulators, and/or the links and joints of the device. It may be arranged differently depending on the location. According to some embodiments, the coordinate frames and transformations of kinematic model 300 may be used to model coordinate frames and transformations associated with one or more virtual devices and/or virtual cameras. In some examples, the virtual device and/or camera may be associated with previously stored and/or latched device positions, projections of the device and/or camera due to movement, reference points defined by a physician and/or other personnel, etc. It can be.

As described above, when a computer-assisted system, such as computer-assisted device 100 and/or 200, is operating, movement of a surgical table, such as surgical table 170 and/or 280, is permitted while the device and/or Alternatively, it would be desirable to allow continuous control of the end effector. In some instances, this may allow for a less time consuming procedure because surgical table movement occurs without the need to remove the instrument from the patient's body opening. In some instances, this allows the physician and/or other medical staff to monitor organ movement while operating table movement is occurring to achieve a more optimal operating table pose. In some instances, this also allows for active continuity of the procedure during surgical table movements. Some modes of operation allow movement of the articulated structure of the surgical table (i.e., table movement) while one or more instruments are inserted into the patient and into a body opening above the patient. Examples of systems that allow for active continuation of a procedure during surgical table movement include U.S. Provisional Patent Application No. 62/134,207, entitled “System and Method for Integrated Surgical Table,” filed March 17, 2015, and co-filed, ISRG006930PCT/ It is described in greater detail in the PCT patent application entitled “System and Method for Integrated Surgical Table,” bearing attorney number 70228.498WO01, both of which are hereby incorporated by reference in their entirety. Typically, during table movement, a remote center of motion or other control point, corresponding to the body opening, body cavity, and/or location through which the device is inserted through the patient's incision site, moves with the patient to determine the patient's anatomy at the incision point. It is desirable to limit stress on enemy structures and/or maintain device positioning. In some examples, this is accomplished using device dragging by releasing and/or unlocking one or more joints of the articulated arm and allowing the patient's body walls of the body opening to drag the control points and associated devices as the patient moves. It can be. However, the articulated arm and/or end effector may occasionally encounter disturbances that cause it to lose its ability to freely track table movement, leaving the control points inconsistent with the body aperture. Examples of disturbances that can cause loss of tracking include reaching the limited range of motion of a joint of an articulated arm, obstructions such as tangled cables, loss of cannula retention (i.e., control points associated with slipping from the body wall at the body opening), cannula), movement of the character on the table, failure to release the brake, collision between two arms and/or between the arm and the patient's body, etc. Accordingly, in some instances, it may be desirable to monitor the configuration of the control points during table movement to ensure that the configuration of the control points at a given time matches the expected configuration based on table movement. When a deviation between the actual configuration of the control point and the expected configuration is detected, corresponding corrective action can be taken, such as disabling the table movement, braking the articulated arm, issuing an alarm to the user, etc. Additionally, according to some embodiments, detecting and/or reporting problematic arms (i.e., one or more articulated arms that have received and/or are most affected by the disturbance that triggered the alert) to aid corrective action. This may be desirable.

4 is a simplified diagram of a method 400 for monitoring one or more control points during table movement in accordance with some embodiments. When at least a portion of one or more of the processes 410-460 of method 400 is executed on one or more processors (e.g., processor 140 of control unit 130), such one or more processors execute one or more of the processes 410-460. The code may be implemented in the form of executable code stored on a non-transitory, tangible, machine-readable medium capable of performing the following: In some embodiments, method 400 may be used to detect disturbances that prevent control points, such as those located at a patient's body opening, body cavity, or incision site, from tracking table movement as expected. In some examples consistent with the embodiment of FIG. 2 , one or more of these control points may be an example of a remote center of motion 274 and table movement may correspond to movement of the articulated structure 290 of the surgical table 280. . Those skilled in the art will appreciate that method 400 can be applied to monitor movement of a remote center of motion or any other control point that is expected to move predictably as a result of table movement.

According to some embodiments, method 400 supports one or more useful enhancements to the method of not monitoring one or more control points during table movement. In some examples, method 400 may be used during table movement by detecting a disturbance that prevents the control point from freely tracking the table movement and allowing corresponding corrective action to be taken, such as stopping the table movement and/or alerting the operator to the disturbance. Reduces the likelihood of damage to patients or equipment. In some examples, method 400 may also assist driver intervention by reporting one or more problematic arms that are disturbed and/or most affected by the disturbance. In some examples, method 400 may lower the likelihood of false alarms over other methods by monitoring a selected set of geographic attributes of the control point configuration and/or by setting thresholds that accurately distinguish routine aberrations from unsafe disturbances. .

In process 410, the latch configuration of the control point is determined. This latch configuration defines one or more properties of the geographical arrangement of control points (together referred to as control point clusters) in a frame of reference. In some embodiments, these geographic properties may include the location of control points, the direction of the control point cluster, the point-to-point distance between pairs of control points, the interior angle formed between the sets of three control points, the center of curvature of the control point cluster, etc. In some examples, such latch configurations may use sensor readings and/or a kinematic model, such as kinematic model 300, to determine the location of each control point and/or derive the corresponding geographic properties of the control point cluster. can be decided. The selection of this reference frame may depend on the mode of operation. In some embodiments, this frame of reference may be any coordinate frame that is fixed with respect to the world coordinate frame. In this example, consistent with the embodiment of Figures 2 and 3, one of device base coordinate frame 320, arm mounting platform coordinate frame 330, and/or table base coordinate frame 305 will be used as a reference frame. You can. A fixed reference frame can be used in any operating mode to track the position of each control point individually. In some embodiments, such a frame of reference may be a dynamic coordinate frame in which the location and/or orientation of the origin of the axes of this frame of reference depends on the current location and/or orientation of the control point, table top, and/or other moving components of the system. You can. One example of a dynamic coordinate frame is a barycentric reference frame where the origin of the reference frame is the average and/or weighted average position of the control points at the current time and the orientation of the reference frame is fixed with respect to the world coordinate frame or table top coordinate frame. . The barycentric reference frame can optionally be used in any operating mode to track the movement of control points relative to each other, in which case a common-mode translation of the control points (i.e., a translation that applies equally to all control points). is irrelevant. Once process 410 is complete, table movement can begin.

In process 420, the expected configuration of control points is determined based on table movement. This expected configuration addresses expected changes in the position and/or orientation of the control point relative to the latch configuration determined during process 410 based on table movement. In some embodiments, this expected configuration may specify a set of geographic properties that correspond to those defined by the latch configuration. In some embodiments, this expected configuration may instead and/or additionally define one or more differential properties specified relative to the latch configuration, such as change in position, change in direction, etc. In some instances, such as when using device dragging, the control point is expected to move with the table. In this embodiment, for example, when the height of a table changes by a given distance, the vertical positions of each of the control points in the fixed frame of reference are expected to change by the same distance. Likewise, when the table is rotated by a given angle, such as a tilt, Trendelenburg, and/or reverse Trendelenburg rotation, the control point cluster in the barycentric frame of reference is expected to rotate by the same angle. According to some embodiments, one or more geographic attributes of a cluster of control points are expected to remain unchanged during table movement. For example, the interior angles, inter-point distances, and centers of curvature of a group of control points are expected to be constant during table movement.

At 430, the actual configuration of control points during table movement is determined. In some examples, this actual configuration may be determined using position sensors and/or kinematic models to determine the location of each control point and/or the geographic properties of a corresponding group of control points in the frame of reference of process 410. In some embodiments, this actual configuration defines a set of geographic attributes that correspond to those defined by the latch configuration of process 410 and/or the expected configuration determined by process 420.

In process 440, the actual and expected configurations of the control point are compared to determine whether the difference between these configurations exceeds one or more predetermined thresholds. The type and/or value of this predetermined threshold depends on the geographic properties being compared. In some examples, when these geographic attributes include control point locations, these predetermined thresholds represent the maximum allowable distance between the actual location and the expected location. Likewise, when this geographic attribute includes the direction of a cluster of control points, this predetermined threshold represents the maximum allowable angle between the actual and expected directions. In some examples, when these geographic attributes include locations associated with a cluster of control points, such as a central location, this predetermined threshold represents the maximum allowable distance between the actual location and the expected location. In another example, when this geographic attribute includes a center of curvature of a control point cluster, this predetermined threshold represents a constraint that this center of curvature is located below the center of gravity of the control point cluster. Various other types and/or values of predetermined thresholds may optionally be applied to other geographic properties in a manner consistent with the underlying properties of the properties being compared.

Typically, the values of these predetermined thresholds account for routine deviations between the actual and expected configurations (e.g., small vibrations of the articulated arm, small delays due to device dragging, acceptable distortion of the patient's body wall, etc.). They are selected on request to accurately detect unsafe disturbances to the control point configuration while minimizing false alarms from the control point configuration. In some embodiments, the value of one or more of the predetermined thresholds is selected based on a clinically acceptable distance that the control point can move relative to the patient's body during table movement. In some embodiments, this clinically acceptable distance is about 12 mm. Accordingly, in some embodiments, process 440 may include performing one or more calculations to determine a value for a predetermined threshold that is consistent with a clinically acceptable distance to be maintained. These calculations depend on the nature of the geographic properties being compared. For example, when this geographic attribute is an angle, this calculation involves converting this clinically acceptable distance to an equivalent angular value in a frame of reference.

Comparing the actual configuration to the expected configuration to determine whether the difference between these configurations exceeds one or more predetermined thresholds can be accomplished in a variety of ways. Accordingly, the process 440 described above is by way of example only and not limiting. In some instances, the clinically acceptable distances are not converted to a predetermined threshold that matches the geographic properties being compared, but instead, a distance value at which these compared geographic properties are consistent with the clinically acceptable distances. can be converted to According to some examples, without directly comparing the actual configuration to the predicted configuration, a range of acceptable values for a geographic attribute of the actual configuration may be determined based on the expected configuration and a predetermined threshold. According to this example, if the geographic attributes of the actual configuration are not within the range of acceptable values, the predetermined threshold is determined to have been exceeded.

In process 440, if it is determined that one or more predetermined thresholds have not been exceeded, the table movement can proceed and method 400 returns to process 420 to continue monitoring the control point configuration. However, when it is determined that one or more predetermined thresholds have been exceeded, an alert is given and the method 400 proceeds to process 450 described below.

In process 450, one or more control points and the corresponding arm (referred to as the arm in question) that caused the alarm in process 440 are determined. One or more techniques may be used to determine the cancer of this problem. In some embodiments, when a joint reaches a limited range of motion, the articulated arm corresponding to the limited range of motion event may be identified as the arm in question. In some embodiments, an error value associated with each control point is determined, the corresponding articulated arm having the maximum error value (i.e., the arm of the worst problem) and/or one or more corresponding articulated arms having an error value exceeding a threshold. Articulating cancer is identified as one or more problematic cancers. In some embodiments, when the actual configuration and the expected configuration define actual and expected positions for each control point, this error value includes the distance between the actual and expected positions. In some embodiments, this error value includes the difference between the actual path length and the expected path length, which refers to the amount of distance each control point moves during table movement. To illustrate how this path length difference works, the following example is provided. The predicted position is moved 10 units to the right and then 5 units to the left, and the actual position is moved 7 units to the right and then 2 units to the left. Both the actual and expected positions end up 5 units to the right of the starting position after the move, so the distance between the actual and expected positions is 0 units. However, the expected position moved along a path 15 units long and the actual position moved along a path 9 units long, so the difference between the actual path length and the expected path length is 6 units. Accordingly, in some embodiments, this path length difference is used to capture as an error value the specific deviation between the actual and expected positions that is ambiguous when using the final distance between the actual and expected positions.

In process 460, one or more corrective actions are taken based on the alert issued in process 440 and/or based on the nature of the problem determined in process 450. In some embodiments, these corrective actions include stopping and/or disabling table movement, alerting the operator of the disturbance, applying compensation to one or more of the articulated arms, logging an error report, and/ It includes one or more of the following: or a dispatch step. In some embodiments, table movement is halted as soon as an alarm is issued and, optionally, the operator can take one or more actions, such as manually repositioning the arm in question and/or running a check to identify and correct the disturbance. It will remain inoperable until In some embodiments, the operator may optionally use audio, visual, and/or haptic signaling mechanisms, such as audio alarms, flashing lights (e.g., LEDs), messages on a display screen, vibration of the surgical table command unit, etc. An alert may be given for. Likewise, such problematic cancers may optionally be reported to the driver using any suitable signaling mechanism, such as the audio, visual, and/or haptic signaling mechanisms described above. In some embodiments, a brake may be fully and/or partially applied to one or more of the articulated arms, including the arm in question and/or all articulated arms, to prevent and/or reduce further movement of the control points relative to the table. . In some embodiments, an error signal may optionally be sent to one or more joints of the articulated arm to attempt to compensate for deviations between the actual configuration and the expected configuration by applying a counter force to one or more joints. In some embodiments, an error report containing details related to the alert, such as timestamp, system identifier, driver identifier, cancer identifier in question, etc., is generated locally and locally for information purposes and/or to enable further corrective action to be taken. /or may be logged and/or dispatched to a remote computer application.

As mentioned above and further emphasized herein, Figure 4 is an example only and does not limit the scope of the claims. Those skilled in the art will appreciate many variations, alternatives, and modifications. According to some embodiments, method 400 may omit one or more of processes 410-460. For example, some embodiments may skip the process 450 of detecting the cancer in question and alert the driver of the disturbance without identifying the cancer in question. Some embodiments may omit the process 420 for determining the expected configuration, especially when the geographic properties defined by the latch configuration are expected to not change during table movement (in other words, the expected configuration is the latch configuration determined in process 410). may be equivalent to ). Geographical properties that are expected to remain unchanged during table motion may include interpoint distances between control points, interior angles formed by a set of three control points, the center of curvature of a group of control points in a barycentric frame of reference, etc. This embodiment can be used, for example, when information about the table movement is not available and/or when the table movement is performed without using a registration transformation to translate the table movement into a reference frame of the control point cluster. According to some embodiments, the order of processes 410-460 executed during method 400 may be rearranged and/or one or more of processes 410-460 may be executed concurrently. In some examples, the process 420 for determining the expected configuration may run before, concurrently with, or after the process 430 for determining the actual configuration. In some examples, the process 450 for determining the cancer in question may run before, concurrently with, or after the process 460 for raising the alert. According to some examples, a plurality of predetermined thresholds may be checked during process 440 to trigger corrective actions of varying severity in process 460. For example, when a first predetermined threshold is exceeded, trigger a warning to the driver in process 460 but allow continued table movement, and when a second predetermined threshold is exceeded, trigger table movement in process 460. can be suppressed.

5 is a simplified diagram of control point positions 500 during table movement in height only mode according to some embodiments. Figure 5 shows a trace of vertical position (z axis) versus time ( t axis). In some embodiments consistent with the embodiment of Figure 4, Figure 5 illustrates application of method 400 during table movement in a height only mode (i.e., table movement is limited to translation in the vertical direction). In some examples consistent with FIGS. 2 and 3 , height only mode is used when the number of monitored control points is less than three and/or registration between the surgical table and the computer-assisted device has not been implemented and table base-to-device base translation 325 is performed. Can be executed when unknown.

The expected position 510 and the actual position 520 are traces showing the expected and actual positions of the control point over time, respectively. Predetermined threshold 530 is a range of acceptable positions that correspond to expected positions 510 over time. Phase 540 includes a pre-latching phase 540a, a tracking phase 540b, a non-detected disturbance phase 540c, and a detected disturbance phase 540d. During prelatching phase 540a, no table movement is allowed because control point monitoring has not yet begun. Between pre-latching phase 540a and tracking phase 540b, the latch position of the control point is determined and height-only table movement is subsequently permitted. In an embodiment consistent with Figure 4, this latch location is determined using process 410 where the control point configuration defines the location of the control point in a fixed reference coordinate frame.

During tracking phase 540b, height-only table movement occurs, and the control point freely tracks the table movement. When the table rises as shown in Figure 5, the expected position 510 rises with the table. Actual position 520 approximately tracks expected position 510 during tracking phase 540b, although some small, routine deviations between the actual and expected positions may be observed. In an embodiment consistent with Figure 4, expected location 510 is determined using process 420 and actual location 520 is determined using process 430. The expected position 510 and the actual position 520 may be expressed in a reference frame of the latch position and/or may be expressed differently relative to the latch position. Additionally, during tracking phase 540b, the expected position 510 and the actual position 520 are compared to determine whether the actual position 520 is within an acceptable range given by the predetermined threshold 530. In an embodiment consistent with Figure 4, this comparison is performed using process 440 where the value of the predetermined threshold is set to a clinically acceptable distance, such as 12 mm. Although only the vertical component of the range of acceptable positions is shown in FIG. 5 for purposes of understanding, this comparison can be carried out in three dimensions so that deviations in any direction between the expected position 510 and the actual position 520 are detected. You must understand that it can happen. Accordingly, in some embodiments, this range of acceptable locations forms a three-dimensional sphere of acceptable locations. As shown in Figure 5, the difference between the expected position 510 and the actual position 520 during tracking phase 540b does not exceed a predetermined threshold 530.

Between the tracking phase 540b and the undetected disturbance phase 540c, a disturbance 550 occurs that prevents the control point from freely tracking table movement. Disturbance 550 may include one of the disturbances described above with respect to FIG. 4, such as encountering an obstacle that blocks the control point from rising above a given height, as shown in FIG. 5. Accordingly, during the undetected disturbance phase 540c, the actual location 520 no longer closely tracks the expected location 510. However, the actual location 520 and the expected location 510 do not yet exceed the predetermined threshold 530. Accordingly, table movement is allowed to continue as long as the distance between the actual position 520 and the expected position 510 approaches the predetermined threshold 530.

Between the undetected disturbance phase 540c and the detected disturbance phase 540d, the distance between the actual location 520 and the expected location reaches the predetermined threshold 530, and an alarm is generated. In an embodiment consistent with Figure 4, detection of the cancer in question using process 450 and/or corrective action using process 460 may subsequently occur at the beginning of detection perturbation phase 540d. In the embodiment shown in FIG. 5 , table movement is disabled during the disturbance detection phase 540d such that the difference between the actual position 520 and the expected position 510 does not increase above the predetermined threshold 530. Additionally, when more than one control point is being monitored, one or more offending arms may be detected, for example, by identifying the control point with the maximum difference between the actual and expected positions and/or when a predetermined threshold 530 is exceeded. By identifying all of the control points, they can be determined using one of the mechanisms described above for process 450. Optionally, the driver may be prompted to indicate that a disturbance and/or problem cancer has been detected by one of the feedback mechanisms described in connection with process 460, such as an audible alarm indicating that a disturbance has been detected and/or a flashing light to indicate a problem cancer. We can turn our attention to identity. In some embodiments, table movement may remain stationary until the operator addresses the disturbance, for example, by manually repositioning one or more offending arms.

As described above and further emphasized herein, Figure 5 is an example only and does not limit the scope of the claims. Those skilled in the art will appreciate many variations, alternatives, and modifications. According to some embodiments, the z-axis in Figure 5 may represent any geographic attribute of the control point cluster, including vertical or horizontal position, orientation, point-to-point distance, interior angle, etc. Accordingly, procedure 500 may demonstrate a method for monitoring arbitrary geographic properties of a cluster of control points.

6 is a simplified diagram of a cluster of control points 600 during rotary table movement according to some embodiments. Figure 6 shows a three-dimensional arrangement of a group of control points in a barycentric reference frame with the origin located at the average position of a plurality of control points. In some embodiments consistent with the embodiment of Figure 4, Figure 6 illustrates application of method 400 to table movement in modes that allow rotation, such as tilt, Trendelenburg, and/or reverse Trendelenburg rotation. there is. In some examples consistent with FIGS. 2 and 3 , rotation is performed when the number of monitored control points is at least three and/or when the registration transformation 325 is known, such as after registration between the surgical table and the computer-assisted device has been performed. Table movement may be permitted.

Expected configuration 610 includes paths 610a-c that represent the expected positions of control points in the control point cluster 600 over time, and actual configuration 620 includes paths 610a-c that represent the actual positions of control points over time. Containing paths 620a-c, predetermined thresholds 630 include a range of acceptable locations 630a-c that correspond to expected configurations 610 over time. Reference frame 640 represents a center-of-gravity reference frame used to determine control point locations. Before rotating the table and/or determining the latch configuration of the control point cluster, the registration transformation is determined. 2 and 3, the registration transformation may correspond to registration transformation 325 and/or alternative registration transformation 325 and may be determined using θ _z registration and/or XY registration. there is. Accordingly, rotation of the table about table base coordinates 305 by a given angle can be converted to device base coordinates 320 by application of a registration transformation 325.

At the beginning of the table movement, and after θ _z registration and/or XY registration, the latch configuration of the control point cluster is determined. In some embodiments consistent with the embodiment of Figure 4, this latch configuration is determined using process 410 in reference frame 640 prior to table movement. This latch configuration defines one or more geographic properties of the control point cluster, such as the location of each control point and/or the magnitude of the angle formed by the control point cluster with respect to the reference frame 640 prior to table rotation. Once these latch configurations are determined, control point monitoring during table movement begins. In some embodiments, consistent with the embodiment of Figure 4, control point monitoring uses processes 420-440 to determine whether the actual configuration of the control point swarm deviates more than a predetermined threshold 630 from the expected configuration of the control point swarm. It runs. Because the reference frame 640 is the center of gravity, translational movements of the table, such as height adjustments, slide adjustments, and/or translational movements corresponding to rotational movements of the table in a non-isocentric position, may be performed in the expected configuration 610. don't change Meanwhile, rotational movement of the table changes the direction of the expected configuration 610, and the direction and magnitude of this change are determined using the detected table movement and the registration transformation. It should be noted that although the actual center of the control point cluster may be translational, since the coordinate frame 640 is centroid, this actual center is merely a relative position to the center of the control point cluster being considered.

The control point cluster 600 illustrates a rotation that causes a change in the direction of the expected configuration with respect to the reference frame 640. As in the example shown in FIG. 5 , actual configuration 620 tracks expected configuration 610 approximately within a predetermined threshold 630 . For purposes of understanding, the geographic attribute shown in FIG. 6 is location, but other geographic attributes, such as the magnitude of the angle formed by the actual configuration 620 with respect to the reference frame 640, are also compared to the expected configuration 610 and correspond to It should be understood that the rotation size can be checked (i.e., the rotation size is checked) against a certain threshold.

Control point cluster 600 also illustrates a perturbation 650 that causes control point path 620c to deviate from expected path 610c beyond an acceptable range 630c. In some embodiments, consistent with the embodiment of FIG. 4 , the crossing of a threshold triggers an alert during process 440 to trigger one or more of the processes of identifying cancer in question 45 and/or corrective action 46 . In some embodiments, the arm in question corresponding to control point path 620c is configured using one of the mechanisms described above for process 450, for example, by identifying the control point with the maximum difference between the actual and expected path lengths. can be decided. In some embodiments, such as when performing a rotational size check, all of the arms may be identified as problematic arms. The driver may be brought to the attention of the detected disturbance and/or the identity of the arm in question by one of the feedback mechanisms described for process 460, such as an audible alarm indicating that a disturbance has been detected and/or a flashing light indicating the arm in question. You can.

As stated above and further emphasized herein, Figure 6 is merely an example and does not limit the scope of the claims. Those skilled in the art will appreciate many modifications, alternatives, and modifications. In some embodiments, the control points may be approximately collinear (i.e., forming approximately a straight line rather than a triangle, etc.), in which case sensitivity to rotational movement along one or more axes may be reduced. In such embodiments, one or more compensatory actions are taken when a low sensitivity configuration is identified, such as inability to move the rotary table, reducing a predetermined threshold, issuing an alert to the driver about the reduced sensitivity, and/or increasing the uncertainty of the surveillance. can be taken

Some examples of control units, such as control unit 130, include executable code that, when executed by one or more processors (e.g., processor 140), can cause such one or more processors to execute the processes of method 400. It may include non-ephemeral, tangible, machine-readable media. Some common forms of machine-readable media that may include the process of method 400 include, for example, floppy disks, flexible disks, hard disks, magnetic tapes, any other magnetic media, CD-ROMs, any other optical media, punch cards, paper tapes, any other physical media with a pattern of holes, RAM, PROM, EPROM, FLASH-EPROM, any other memory chip or cartridge, and/or any other media configured to be read by a processor or computer. .

Although embodiments have been shown and described, a wide range of modifications, changes and alternatives are possible herein and in some instances, some features of these embodiments may be employed without corresponding use of other features. Those skilled in the art will recognize many variations, alternatives and modifications. Accordingly, the scope of the invention should be limited only by the following claims, which are appropriately interpreted broadly and in a manner consistent with the scope of the embodiments disclosed herein.

Claims (15)

In a computer-assisted device,
A plurality of articulated arms having a plurality of control points, wherein each articulated arm of the plurality of articulated arms has one control point among the plurality of control points, and the plurality of articulated arms and the corresponding plurality of control points are in separate tables. a plurality of articulated arms configured to track movement; and
comprising a control unit coupled to the plurality of articulated arms;
The control unit:
determining a latch space configuration of the plurality of control points prior to movement of the separate tables, wherein the latch space configuration defines one or more geographic attributes of the plurality of control points;
determining a real spatial configuration of a plurality of control points during movement of the separate tables; and
and determining a difference between one or more geographic properties of the latch spatial configuration and a corresponding one or more geographic properties of the real spatial configuration. The method of claim 1, wherein the one or more geographic attributes are:
inter-point distance between two plurality of control points; or
an interior angle formed between three plurality of control points; or
A computer-assisted device, comprising a relative position of one of a plurality of control points with respect to the center of a cluster of control points formed from the plurality of control points. The method of claim 1, wherein the one or more geographic attributes are:
A computer-assisted device comprising a latch spatial configuration and the magnitude of an angle between a reference frame. The method of claim 3, wherein the reference frame is:
Center of gravity reference frame; or
world coordinate frame; or
A computer-assisted device comprising a tabletop coordinate frame of separate tables. 4. The computer-assisted device of claim 3, wherein the frame of reference is determined based on an operating mode of the computer-assisted device. The method of any one of claims 1 to 5, wherein the movement of separate tables is performed by:
height adjustment; or
Slide adjustment; or
A computer-assisted device comprising translational movements corresponding to rotational movements of separate tables. 6. The computer-assisted device of claim 1, wherein the plurality of articulated arms and the plurality of control points are configured to track movement of separate tables using mechanical dragging. 6. The method according to any one of claims 1 to 5, wherein the control unit:
further configured to perform corrective action when the difference is greater than a threshold;
Corrective actions include: disabling movement of separate tables, alerting the operator, reporting problematic articulated arms, applying compensation to one or more articulated arms, and logging errors. A computer-assisted device comprising at least one action selected from the group consisting of: The method according to any one of claims 1 to 5, wherein at least one control point among the plurality of control points is:
a remote center of motion of a first articulated arm of the plurality of articulated arms; or
A computer-assisted device, corresponding to a body opening, body cavity, incision site, or location at which an instrument supported by the computer-assisted device is inserted. 6. The method according to any one of claims 1 to 5, wherein the control unit:
Determine the error value associated with each control point among the plurality of control points,
The computer-assisted device further configured to identify an articulated arm among the plurality of articulated arms having a maximum error value or an error value exceeding a threshold as the arm in question. 1. A non-transitory machine-readable medium comprising a plurality of machine-readable instructions that, when executed by one or more processors associated with a computer-enabled device, are adapted to cause the one or more processors to perform a method, comprising:
The above method is:
determining, using a control unit of the computer-assisted device, a latch spatial configuration of a plurality of control points prior to movement of the separate tables, each of the plurality of control points being associated with one of a plurality of articulated arms of the computer-assisted device, wherein the latch The spatial configuration includes a decision step, defining geographical properties of one or more of the plurality of control points;
determining an actual spatial configuration among a plurality of control points during movement of a separate table; and
A non-transitory machine-readable medium comprising determining a difference between one or more geographic properties of a latch spatial configuration and one or more corresponding geographic properties of an actual spatial configuration. 12. The method of claim 11, wherein the one or more geographic attributes are:
inter-point distance between two plurality of control points; or
an interior angle formed between three plurality of control points; or
A non-transitory machine-readable medium comprising a relative position of one of a plurality of control points with respect to the center of a cluster of control points formed from the plurality of control points. According to clause 11,
The one or more geographic properties include the magnitude of the angle between the latch spatial configuration and the reference frame;
The frame of reference is:
Center of gravity reference frame; or
world coordinate frame; or
Contains a table top coordinate frame of a separate table;
A non-transitory machine-readable medium, as determined based on the mode of operation of the computer-assisted device. According to any one of claims 11 to 13,
The method further includes performing corrective action when the difference is greater than a threshold;
Corrective actions include: disabling movement of separate tables, alerting the operator, reporting problematic articulated arms, applying compensation to one or more articulated arms, and logging the error. A non-transitory machine-readable medium comprising at least one action selected from the group configured. According to any one of claims 11 to 13,
The above method is:
determining an error value associated with each control point among the plurality of control points;
A non-transitory machine-readable medium further comprising identifying an articulated arm of the computer-assisted device having an error value exceeding a maximum error value or a threshold as the arm in question.